By Asrat Kebede

Nearly $1.2 billion in economic stimulus law funds are now available as grants for health information technology, Vice President Joe Biden announced today. About half of the funding will go to establish dozens of regional education centers across the country, and the other half will help state agencies set up health information exchange systems.

Congress approved the funding as part of the economic stimulus law to promote the adoption of electronic health record (EHR) systems. Lawmakers included $45 billion in incentive payments to doctors’ offices and hospitals that buy and meaningfully use digital health records, and $2 billion to promote health information exchange.

The Health and Human Services Department will issue rulemaking later this year to define the terms of certification and meaningful use.

“With electronic health records, we are making health care safer; we’re making it more efficient; we’re making you healthier; and we’re saving money along the way, ” Biden said in a statement today.

Grants totaling $598 million will be used to get 70 Health IT Regional Extension Centers up and running. The centers will give hands-on help to doctors and hospital staff in selecting, acquiring and deploying certified EHR systems.

An additional $564 million in grants is available to states to support the development of mechanisms for sharing of patient medical information within a framework of an “emerging nationwide system of networks,” the statement said.

Both sets of grants will be issued starting in fiscal 2010. The extension program grants will be awarded on a rolling basis: 20 in the first quarter of the fiscal year, 25 in the third quarter, and the remainder in the fourth quarter.

HHS will dedicate $50 million to creating the Health IT Research Centers will help the regional extension center identify and share best practices and collaborate with each other, the statement said.

The centers together will support at least 100,000 primary care providers, through participating nonprofit organizations, in achieving meaningful use of EHRs, the statement said.

The health information exchange grants will be awarded through the State Health Information Exchange Cooperative Agreement Program. States may choose to enter multistate arrangements. State agencies will be required to provide matching funds starting in 2011.

A group sponsored by the National Governors Association recently advised state agencies to begin their planning on health information exchanges, which will be required to achieve meaningful use of digital health records.

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http://www.ethiopianreview.com/scitech/1620

By the Associated Press

President Barack Obama, faced with falling approval ratings and increasingly impatient with Senate negotiations over health care, is weighing a shift in strategy that would offer more details of his goals for overhauling the nation’s healthcare system.

The president is considering a speech in the next week or so in which he would be “more prescriptive” about what he feels Congress must include in a bill, top adviser David Axelrod said Tuesday in an interview. The speech might occur before the Sept. 15 deadline the White House gave to Senate negotiators to seek a bipartisan bill, Axelrod said. He suggested that two key Republicans have not bargained in good faith.

Congress reconvenes next Tuesday after an August recess in which critics of Obama’s health proposals dominated many public forums.

Some Obama allies, watching his approval ratings tumble in polls along with support for a healthcare overhaul, have urged the president to take a more hands-on approach. They feel he gave too much leeway to Congress, where one bill has passed three House committees, another has passed a Senate committee and a third has been bogged down in protracted negotiations in the Senate Finance Committee.

Axelrod indicated that Obama would not offer new proposals but would be more specific about his top priorities.

“The ideas are all there on the table,” Axelrod said. “Now we are in a new phase, and it’s time to pull the strands of these together.”

He said there is serious discussion in the White House of Obama “giving a speech that lays out in specific ways what he thinks” about the essential elements of a healthcare bill.

Axelrod said it was possible that the speech could occur before a planned Sept. 15 Obama address on healthcare in Pittsburgh.

Obama has called for innovations such as a public health insurance plan to compete with private insurers, but he has not insisted on it. It was not clear Tuesday the degree to which he might press for various proposals in a new speech.

Obama also plans to meet with Democratic congressional leaders on Tuesday.

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http://www.modernhealthcare.com/article/20090902/REG/309029973/-

Source: US National Governors’ Association

As the national dialogue on health care reform continues, health information technology (IT) and health information exchange (HIE) have emerged as critical means to ensuring a health care system that is affordable, effective, safe and transparent. A new report from the State Alliance for e-Health, Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange, aims to help states lead the way in using health IT and HIE and guide them as they begin instituting the federal Health Information Technology for Economic and Clinical Health (HITECH) Act.

The State Alliance for e-Health, a consensus-based, executive-level body composed of governors, state legislators, attorney generals and state commissioners, was created by the NGA Center for Best Practices in 2006 to address the unique role states can play in facilitating adoption of health IT and HIE. The HITECH Act, enacted as part of the 2009 American Recovery and Reinvestment Act, expands the role of states in fostering health information exchange and adoption of electronic health records over the next five years.

“Governors understand that swift and thoughtful action is needed at the state level to plan and implement a national system of health information exchange, “said Tennessee Gov. Phil Bredesen, co-chair of the State Alliance. “Widespread adoption and use of electronic health records provide a critical foundation for improving health outcomes and cost-effectiveness.”

The report recommends actions states should begin undertaking now to successfully implement the HITECH Act, including:

• Preparing or updating the state plan for HIE adoption;
• Engaging stakeholders;
• Establishing a state leadership office to manage the different phases of HIE implementation;
• Preparing state agencies to participate; implementing privacy strategies and reforms;
• Determining the HIE business model;
• Creating a communications strategy; and
• Establishing opportunities for health IT training and education.

“States already have taken the lead in modernizing the health care system by advancing the use of health IT, electronic health records, e-prescribing and electronic exchange of health information,” said Vermont Gov. Jim Douglas, NGA Chair and co-chair of the State Alliance. “We now have an opportunity to accelerate adoption of health IT across the states and create a truly comprehensive health care system that is effective, affordable and accountable.”

The report and state initiatives to implement health IT and electronic HIE will provide a central focus for the State Alliance for e-Health’s semi-annual conference, to be held August 7 in Burlington Vermont.

The State Alliance – supported by funding from the U.S. Department of Health and Human Services – provides a nationwide forum through which governors, state policymakers and other stakeholders can work together to identify effective HIT policies and best practices and explore solutions to challenges related to the exchange of health information.

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http://www.egovmonitor.com/node/27565

By Neil Versel

Dr. David Blumenthal, the national coordinator for health information technology, gave a strong indication of how HHS ultimately will define “meaningful use,” the standard that providers must meet to be eligible for Medicare and Medicaid EMR bonuses, by warning that hospitals unwilling to share data with others risk being shut out of the stimulus funding. “There’s a fair amount of money in the law for hospitals that adopt interoperability,” the Dallas Morning News quotes Blumenthal as saying. “If they don’t, they’re not likely to be eligible for payment.”

Although the three largest hospital operators in the Dallas-Fort Worth are implementing EMRs, there is no means for health information exchange between the systems or with smaller providers. The Dallas-Fort Worth Hospital Council is only now working on an HIE feasibility study, and is seeking grant funding to lay the groundwork for data sharing, the newspaper reports.

In McAllen, TX, recently named the second-most-expensive healthcare market in the country, one physician executive believes that interoperability could help rein in some of the spending.

Let me know for further assistance.

http://www.fierceemr.com/story/blumenthal-must-share-data-get-stimulus-money/2009-06-25

By Anne Zieger

The Agency for Healthcare Research and Quality has announced that it will provide a series of grants totaling $48 million that can be used to develop national patient registries for comparative effectiveness research. Clinical registries are one of a number of approaches to helping providers identify the long-term effects of treatments, along with clinical data networks and other forms of health IT networking.

This is part of a larger $300 million grant and contract package designed to fund comparative effectiveness projects funded by the federal stimulus package. The AHRQ will offer grants to study treatment benefits focused on 14 common conditions, including diabetes, obesity and heart and blood vessel problems.

AHRQ will also seek $74 million in contracts for analyzing and generating evidence, along with $19.5 million to establish an infrastructure for identifying the right treatment issues to focus on as part of comparative effectiveness reviews.

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http://www.fiercehealthit.com/story/ahrq-handing-out-48m-grants-comparative-effectiveness-research/2009-08-16

By Mary Mosquera

The Obama administration is expected to announce as early as Friday plans to award a series of grants to assist healthcare providers acquire and use health IT properly as well as to help states set up health information exchanges.

National health IT coordinator Dr. David Blumenthal is scheduled to join Vice President Joe Biden and HHS Secretary Kathleen Sebelius Aug. 20 for a discussion with physicians, nurses and administrators from Chicago’s Mt. Sinai Hospital. They are expected to discuss health reform, including health IT infrastructure and preventative care, according to a White House statement.

The American Recovery and Reinvestment Act provided the Office of the National Coordinator $2 billion to promote the meaningful use of health IT. Up to $300 million was intended to help establish state HIEs; another share would fund regional training centers to help physicians and hospitals incorporate health IT into their practices.

In an e-mailed statement today, Blumenthal laid out the administration’s case for the importance of the health IT funding targets.

Nationwide electronic HIE “provides the best opportunity for each patient to receive optimal care,” Blumenthal said. The technology will make patients’ complete medical information securely available to their health care providers where and when it is needed, “when clinician and patient are together facing medical decisions that can make a lasting difference.”

“My personal belief in this transformation is not based on theory or conjecture,” said Blumenthal, who has been a primary care physician for 30 years.

“I spent the first 20 shuffling papers in search of missing studies and frequently hoping, during middle-of-the-night emergencies, that I knew enough about patients’ medical histories to make good decisions. All that changed when I began to have access to patients’ electronic medical records,” he said, adding that it made him a better doctor. He started using electronic records 10 years ago.

With the U.S. spending $2.5 trillion annually on healthcare, it is clear that change is necessary, he said. “Better, faster, more reliable and efficient care also ultimately reduces system-wide costs,” he said.

To realize the benefits of a nationwide health information system will also require that personal health information remain private and secure. “Putting into place safeguards for the privacy and security of this information, when it is in electronic form, will be an ongoing priority that influences and guides all of our efforts,” he said.

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http://www.govhealthit.com/newsitem.aspx?nid=71989

DENIS STAUNTON in Washington

US PRESIDENT Barack Obama has promised to overhaul the American healthcare system by the end of this year – without Republican support if necessary.

Speaking in Indiana after a town hall meeting to promote his economic policies, the president said he would prefer to sign a bipartisan healthcare Bill but it was not yet clear if negotiations with Republicans would prove fruitful.

“Sometime in September we’re going to have to make an assessment,” he told MSNBC. “I promise you, we will pass reform by the end of this year because the American people need it.”

Mr Obama told his audience in Elkhart, which experienced the sharpest unemployment rise in the US last year, that he would issue $2.4 billion in taxpayer grants to create electric cars and tens of thousands of jobs.

“For too long, we failed to invest in this kind of innovative work, even as countries like China and Japan were racing ahead,” he said.

“That’s why this announcement is so important – this represents the largest investment in this kind of technology in American history.”

Mr Obama identified energy, innovation, healthcare and education as the pillars of the new US economy he wants to build from the wreckage of the recession.

“Now, there are a lot of people out there who are looking to defend the status quo. There are those who want to seek political advantage. They want to oppose these efforts.

“Some of them caused the problems that we got now in the first place, and then suddenly they’re blaming other folks for it. They don’t want to be constructive. They don’t want to be constructive; they just want to get in the usual political fights back and forth,” he said to applause.

“But you and I know the truth. We know that even in the hardest times, against the toughest odds, we have never surrendered. We don’t give up. We don’t surrender our fates to chance. We have always endured. We have worked hard, and we have fought for our future.

“Our parents had to fight for their future; our grandparents had to fight for their future. That’s the tradition of America.

“This country wasn’t built just by griping and complaining. It was built by hard work and taking risks. And that’s what we have to do today.”

Republicans, who have opposed all Mr Obama’s key proposals, from the economic stimulus package to healthcare reform, see in the president’s declining popularity an opportunity to make gains in next year’s congressional elections.

“President Obama is now looking like a mere mortal, as opposed to someone who previously exceeded gravity,” said John Cornyn, chairman of the National Republican Senatorial Committee.

“I think there will be a significant number of voters who, leading up to 2010, will wonder if they voted for someone they didn’t get.”

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http://www.irishtimes.com/newspaper/world/2009/0806/1224252080737.html

By Adriel Bettelheim

President Obama plans to huddle with his Cabinet and top advisers on Friday and Saturday to review lessons learned from his first six months in office. There’s bound to be some gnashing of teeth over the pace of the health care overhaul, and also some satisfaction over signs the economy is staggering back.

But based on his remarks at Wednesday’s town halls in Raleigh, N.C. and Bristol, Va., don’t expect a major recalibration of the administration’s message.

Obama continued to strenuously defend economic relief efforts launched in the aftermath of last fall’s financial crisis and lay some blame at the feet of former President George W. Bush. And he eagerly portrayed himself as a responsible steward of taxpayers’ money, to deflect persistent Republican charges that he’s incapable of controlling federal spending.

“I know that some critics in Washington think we’ve been slow to get these projects started,” Obama said in Raleigh, referring to work funded by the $787 billion economic stimulus package (PL 111-5). “They are saying we should have broken ground on all our highway projects on the first day. But everyone knows that’s impossible, especially because I wanted to be sure we did our homework and invested tax dollars only in those projects that actually created new jobs and jumpstarted our economy.”

Speaking in a state where the jobless rate is 11 percent, Obama said while there’s still much work left to be done to assure a complete recovery, “there is little debate that these steps, taken together, have helped stop our economic freefall.”

Obama also fired back at critics who blame him for running up the federal deficit, saying he inherited a $1.3 trillion shortfall. Without mentioning Bush by name, Obama said the staggering deficit was “a debt that is partially a result of two tax cuts that went primarily to the wealthiest few and a Medicare drug program, none of which was paid for.”

Finally, Obama continued to subtly recalibrate his health care message, casting the debate as one that revolves around curbing insurance companies’ less-savory business practices.

He outlined a series of consumer-protection measures aimed at preventing health plans from denying coverage to individuals who have preexisting medical conditions, dropping coverage for individuals who become seriously ill or charging unlimited out-of-pocket expenses. He also said the health overhaul would force the plans to pay for preventive care and routine checkups and remove arbitrary caps on the amount of coverage individuals can receive in a given year or in a lifetime.

Of course, many of these proposals aren’t major sticking points in the current debate. But talk about contentious stuff like public insurance options and how to pay for the overhaul should probably best be left to staff retreats and closed-door negotiating sessions on Capitol Hill.

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http://blogs.cqpolitics.com/balance_of_power/2009/07/
obama-defends-stimulus-health.html

As President Obama continued his push to reform the U.S. health care system, he highlighted the Cleveland Clinic as a model for how effective health IT systems can improve care and lower costs, Healthcare IT News reports.

Obama visited the Cleveland Clinic on Thursday and viewed a presentation on the center’s health IT initiatives.

Cleveland Clinic executives also spoke with the president about patient-centered health IT projects involving Microsoft HealthVault, Google Health and MyChart. MyChart currently connects 202,000 patients to an online portal for appointment scheduling, prescription management, preventive health reminders and test results.

C. Martin Harris, Cleveland Clinic’s CIO and a member of HHS’ Health IT Standards Committee, said the center “is developing health IT that gives patients the power to better manage their health care.”

Harris added that the Cleveland Clinic is “focused on helping lead the nation toward a comprehensive electronic medical records system that will reduce medical errors, improve quality and lower costs.”

During a town-hall meeting later that day, Obama said the Cleveland Clinic has “one of the best health IT systems in the country.” He said the center’s electronic health technology allows it to:

• Boost patient care;
• Coordinate with other health workers in the community;
• Improve chronic disease management;
• Monitor treatment efficacy;
• Reduce duplicate testing; and
• Track patient health and progress.

Obama said, “And here’s the remarkable thing: They actually have some of the lowest costs for the best care” (Monegain, Healthcare IT News, 7/24).

Ezekiel Emanuel, a physician and health policy adviser to the Obama administration, said the Cleveland Clinic has a “fantastic health IT system, which is a necessary component of changing the game” in health care reform (Brown, Washington Post, 7/23).

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http://www.ihealthbeat.org/Articles/2009/7/24/Obama-Continues
-To-Tout-Health-IT-as-a-Key-to-Health-Reform.aspx

By Kim Landers for The World Today

United States President Barack Obama is battling slumping poll numbers as he tries to counter the growing criticisms of his economic and health policies.

Mr Obama has used a prime time media conference to defend his campaign to overhaul America’s health system, calling it vital to pulling the economy back from the brink.

It was his 10th news conference since taking office six months ago and the timing was critical.

The President held it during prime time in the US to guarantee a national television audience. And he did it in a bid to convince Americans and the Congress to back his ambitious health care reforms.

“This debate is not a game for these Americans and they can’t afford to wait any longer for reform. They’re counting on us to get this done. They’re looking to us for leadership and we can’t let them down,” he said.

With the US in a deep recession, unemployment rising and the deficit ballooning, healthcare reform is set to be Barack Obama’s biggest test yet.

Forty-seven million Americans do not have health insurance but the President’s far reaching plans to bring affordable health care to all Americans have left many worrying who will foot the bill.

The growing public unease with his approach is partly due to an onslaught from his Republican critics and some within his own Democratic Party remain sceptical.

But Barack Obama says the time is right for a health care overhaul.

“I’m the President of the United States so I’ve got a doctor following me every minute which is why I say this is not about me,” he said.

“I’ve got the best health care in the world. I’m trying to make sure that everybody has good health care, and they don’t right now. “

‘Back from the brink’

America’s health care costs are a huge factor in the skyrocketing deficit and the President has also used his prime time media appearance to defend his economic policies.

“We’ve been able to pull our economy back from the brink,” he said

“We took steps to stabilise our financial institutions and our housing market and we passed a recovery act that has already saved jobs and created new ones.”

But six months after taking office Mr Obama’s popularity is fading. A Gallup poll shows his approval rating has dipped to 55 per cent.

The White House says they are “darn good numbers” but at the same point in his White House tenure George W Bush was on 56 per cent, Jimmy Carter was on 67 and Bill Clinton was on 41 per cent.

Bill Clinton was the last President to try and very publicly fail to reform health care.

Policy concerns

Darrell West is the vice-prsdsesident and the director of Governance Studies at the Brookings Institution. He is not marking Barack Obama’s six month report card too harshly.

“His poll numbers are starting to slip, unemployment is getting close to 10 per cent and Americans are starting to have a few doubts about some of the current directions of his policy initiatives,” he said.

Jennifer Duffy is a senior editor with the Cook Political Report, an independent newsletter. She says any president who started with such high popularity has to endure some erosion.

“But what we’re really seeing here is not that so much that he’s becoming less popular but that voters have some concerns about his policy,” she said.

“They still like him. They just have concerns about health care. They have concerns about whether the stimulus package is working.”

President Obama has again stressed today that he inherited the worst recession in half a century.

But Ms Duffy says Americans seem keen to put talk of the past behind them and they are now grading the new President on how he is handling the economy, particularly the impact of his $2 trillion stimulus package.

“First of all Americans are pretty fond of instant gratification,” she said.

“The stimulus I think may be the very first example of that and I think the White House has tried to reset the expectations to a certain degree but in a number of states, especially in the mid-west, we have had failing economies much longer than other states. Asking for patience is a hard thing.”

As one commentator in the United States put it, the icy cool President Obama is finally starting to sweat.

Above article published on

http://www.abc.net.au/news/stories/2009/07/23/2634633.htm